Bundle 1

Question 1

local anaesthesia def.
advantages. contraindications
overdose and sideeffects

Answer 1

Local anesthetics (LAs) block the generation and propagation of nerve impulses at several sites - the spinal cord,
spinal nerve roots or peripheral nerves - by inhibiting Na+ channels in nerve fibers, which are essential for the propagation of nerve impulses (membrane)

Advantages. Avoids complications of GA.. Contributes to postoperative analgesia. Less postoperative nausea and vomiting. Patient satisfaction (e.g. in C-section, can see baby right after). Reduces incidence of DVT
Disadvantages.: Toxic effects of local anesthetics. Patient unhappy to be awake. Can be slow onset. Inadequate anesthesia.

Overdose -+ toxicity, manifesting as: * seizures - Tinnitus, metallic taste, perioral paresthesia * Methemoglobinemia –+ cyanosis, gray skin color, fatigue * arrhythmias, coma and cardiovascular collapse.

Side effects: - Allergy Acute: anaphylaxis (rare) Delayed: pruritic rash with blisters at site of LA injection within 72 hours of administration - Vasovagal syncope - Systemic toxicity

Question 2

Local anaesthesia route

Answer 2

Biers Block
Infiltration
Topical
Nerve Block  
Epidural anaesthesia
Spinal intrathecal anaesthesia

Question 3

thyroid nodule workup

Answer 3

TSh